Medical students ... as others see us

Article Abstract:

Several recently published studies regarding medical students are reviewed. One study revealed that about 20 percent of medical students made their decision to become physicians during childhood. Another suggested that students at the top of their medical school classes felt compelled to narrow their interests to medical topics; on a test designed to assess cultural literacy, the top medical students did not do as well as students who were ranked in the lower quarter of their class. It has also been reported that approaches to major stresses differ between male and female students; men reported a greater sense of personal mastery over their responsibilities, while women reported a greater reliance on friends as a coping mechanism. Attitudes toward relationships also differ, with men seeking transient relationships and women believing such relationships to be undesirable. A recent study stated that the use of mind-altering drugs by medical students is lower than that of non-medical students of the same age. Over the last 20 years, the use of amphetamine-type drugs has dropped significantly among medical students, from 44 percent to 27 percent. Personality changes over the four-year period of medical school described on self-assessment surveys revealed that students were more irritable and tense during the second and third years, but by the fourth year their personalities had returned to their first-year levels. One researcher described a 'preresidency syndrome' in which the students about to graduate were excessively and prematurely anxious about residency choices and placements. Stress and phobias were found to play a role in choice of specialty. However, medical students who generally avoid stress are not more likely to choose specialty fields that are regarded as being the least stressful. The author concludes that the process of medical education informs students and also molds them.

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Coping with stress

Article Abstract:

It is estimated that one in ten physicians is affected by some form of impairment due to stress. The practice of medicine has many inevitable stress factors, such as dealing with sick patients and responding to emergencies. Even before admission to medical school the enormous stress of very high academic performance often results in narrowing the scope of the social and personal lives of pre-med students and inhibiting their emotional development. Self-esteem and identity are directly tied into academic achievement, while no value is placed on the ability to nurture. As these men and women face the academic and physical demands of medical school and residency, and are further challenged with the emotional demands of being a caregiver, they may feel poorly equipped to cope. The American Medical Association Resident and Medical School Education Committee has agreed that there is a need to develop coping skills during medical school training. A curriculum to be incorporated into medical schools called the Coping Skill Program has been developed. A key element in this program is a self-assessment tool called StressMap which gives the individual student indications of stress and demonstrates what coping skills can be developed. In a pilot study that included seven anesthesiology residents, a 57 percent improvement over the baseline stress level was observed. Being aware of stress factors and attempting to correct them should improve the ability of physicians to function and raise their own comfort levels as well.

Methods, Prevention, Stress management, Stress (Psychology)

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Medical decision making in situations that offer multiple alternatives

Article Abstract:

Increasing the number of options available to medical decision-makers adds complexity to the decision-making process and may sway people to choose the most distinctive option or to maintain the status quo. Researchers surveyed 287 family practitioners, 352 neurologists and neurosurgeons, and 41 legislators to study medical decision-making. Each group of participants was presented with a relevant hypothetical situation and was requested to select a management option from either two or three alternatives. In the hypothetical scenario of an osteoarthritic patient, 72% of family physicians with two treatment options opted to prescribe a drug rather than referring the patient to a surgeon without drug therapy. Only 53% of family physicians with three treatment options would prescribe one drug over a similar medication or a patient referral without drug therapy. These results were mirrored in the patient prioritization decisions made by neurologists and neurosurgeons and the hospital closure decisions made by legislators.

Decision-making, Decision making

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